Dr. Chasan on the En Bloc Capsulectomy

Dr. Chasan on the En Bloc Capsulectomy

Sep 19, 2019

With the recent news of Anaplastic Large Cell Lymphoma (ALCL) associated with textured implants, there has been a lot of media attention given to the procedure known as “en bloc capsulectomy.” This procedure entails not only removing a breast implant, but also entirely removing the breast capsule that surrounds it. Although there is no scientific evidence that this improves outcomes, many patients feel more comfortable with one-piece removal of the intact capsule containing the implant as there is no potential for spillage of silicone into the pocket.

There are several websites that cater to patients who have significant anxiety regarding their implants and refer to certain surgeons to perform their en bloc capsulectomy suggesting a specific skill set is required to perform this surgery. From a technical perspective, en bloc capsulectomy is a very straightforward procedure that can be performed by virtually every board-certified plastic surgeon. What may be less obvious to patients is that their surgeon’s expertise in performing an artful mastopexy (breast lift) is the differentiating skill set that will most impact their final result. Mastopexy is technically much more difficult when performed at the same time as removing a breast implant, because in its place the surgeon must create a breast mound by rearranging the patient’s own tissues. I believe that after deciding to have their implants removed, a patient’s most important consideration should be choosing a surgeon with mastery of revisionary breast surgery.

At Ranch & Coast Plastic Surgery, we achieved many excellent results with en bloc capsulectomy and mastopexy. In conjunction, we often utilize liposuction contouring of the lateral chest and breast, then use that harvested fat to inject the upper pole of breast. This not only recovers some of the breast volume lost by removal of the implant but enhances the breast shape by effectively redistributing that volume in the most aesthetic manner.